• ARIA;
  • health-related quality of life;
  • persistent allergic rhinitis;
  • XPERT;
  • Xyzal®


The older classification scheme of seasonal or perennial allergic rhinitis (AR) is not entirely applicable in all patients and all regions, since pollens can act as perennial allergens in some parts of the world; the majority of patients are sensitized to multiple allergens, and symptoms of perennial allergy may not be apparent throughout the year. This has resulted in the introduction of the World Health Organisation-initiated Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines, which propose a classification scheme based on both the duration of symptoms and severity of disease, taking into account the patient's quality of life (QOL). The ARIA guidelines are evidence based and classify AR as either intermittent or persistent and of mild or moderate to severe intensity, and recommend treatment options accordingly. Thus, the new classification is much closer to the real-life situation of the patient. The second-generation H1 antihistamines are recommended for all forms of rhinitis, and a recent general population-based study has suggested that these agents may also be useful in the management of patients with persistent AR. The Xyzal® in PErsistent Rhinitis Trial (XPERT) compared the effect of 6-month's treatment with Xyzal® (levocetirizine 5 mg daily) or placebo, on symptoms and QOL in 551 patients diagnosed with persistent AR, according to ARIA. The study demonstrated that Xyzal® significantly decreased the symptoms of disease and improved the health-related QOL in these patients, compared with placebo. Xyzal® also decreased absenteeism and loss of productivity, and therefore reduced the total economic burden of persistent AR and its associated comorbidities, over a period of 6 months. These findings suggest that continuous treatment with Xyzal®, and possibly other antihistamines, if equally potent, is able and may be necessary to improve the QOL of patients with persistent rhinitis and to impact positively on the socio-economic burden of this disease.